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Abstract #1727

Hyperpolarized 13C MRI as a New Tool to Detect Early Treatment Response and Metabolic Heterogeneity in Advanced Renal Cell Carcinoma

Hsin-Yu Chen1, Robert A. Bok1,2, Michael A. Ohliger1, Jeremy W. Gordon1, Ivan de Kouchkovsky2, Daniel B. Vigneron1,2, Peder E.Z. Larson1, Arpita Desai2, and Zhen J. Wang1
1Radiology and Biomedical Imaging, University of Califonia, San Francisco, San Francisco, CA, United States, 2Helen Diller Family Comprehensive Cancer Center, University of Califonia, San Francisco, San Francisco, CA, United States

Synopsis

Keywords: Kidney, Kidney, Hyperpolarized 13C MRI, renal cell carcinoma, pyruvate, treatment response

Motivation: Hyperpolarized (HP) 13C-pyruvate metabolic MRI may provide a solution to the pressing unmet need to discriminate early therapeutic response vs resistance in advanced renal cell carcinoma (RCC).

Goal(s): To evaluate, for the first time, whether pyruvate-to-lactate conversion (kPL) is an early and sensitive response marker to systemic RCC therapies.

Approach: Three patients with advanced RCC underwent HP MRI at baseline and again 3–4-week after treatment initiation (N=2).

Results: HP 13C MRI detected a 50–100% kPL decrease at 4-weeks, prior to definitive clinical radiographic response (~3 months). Inter- and intratumoral metabolic heterogeneity may inform on subsequent therapeutic efficacy.

Impact: Management of advanced/metastatic RCC in the salvage setting is challenging and options are limited. Our initial positive findings highlight how HP 13C MRI’s unique sensitivity to early treatment response/resistance may be leveraged to improve outcomes and avoid toxic, ineffective therapies.

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Keywords